Medical Education Commons^™

A Quality Improvement Project To Reduce Facility-Acquired Pressure Injuries, Carolina Rosario

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Facility-acquired pressure injuries (FAPIs) pose significant risks to patient outcomes and healthcare costs ($500 to $70,000 per PI) in subacute rehabilitation (SAR) facilities. An assessment in a SAR identified a concerning pressure injury (PI) rate of 15.3%, exceeding the national benchmark of 10% for such facilities. This prompted an evidence-based quality improvement (QI) initiative.

Aim of the Project: This project aimed to reduce FAPI rates by 30% or greater among patients 65 and older using a PI prevention bundle called SSKINS (Skin, Surface, Keep moving, Incontinence/moisture, Nutrition/hydration, Self-management).

Review of the Evidence: A comprehensive literature review indicated that PIs …

A Quality Improvement Project: Improving The Clinical Practice For Assessing Hemoglobin A1c On Admission In Diabetic Ketoacidosis Patients Admitted To The Intensive Care Unit, Tiara Lawson

Doctor of Nursing Practice Projects

Background: Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. Early treatment and adherence to guidelines are crucial in preventing DKA. The American Diabetes Association (ADA) publishes annual guidelines for effective DKA management, and the Education Recognition Program National Benchmarks program can help maintain adherence to the published guidelines. Improving the intensive care unit (ICU) admission process enhances the quality of care to DKA patients and improves progress towards national benchmarks.

Purpose: This quality improvement project aimed to improve Hemoglobin A1C (HbA1c) evaluations in DKA patients admitted to the ICU.

Methods: The intervention of triggering HbA1c orders …

July 2024, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

UV Safety Awareness & Parks and Recreation Month

As many of us are enjoying those warm rays this summer, we must remember to protect our skin and eyes from the damaging effects of the sun.

Administrative Time Expectations For Residency Core Faculty: A Cera Study., Bryce A Ringwald, Stephen Auciello, Joseph Ginty, Melissa Jefferis, Stephen Stacey

Medical Education Articles

BACKGROUND: Academic family medicine (FM) physicians aim to balance competing needs of providing clinical care with nonclinical duties of program administration, formal education, and scholarly activity. FM residency is unique in its scope of practice, clinical settings, and training priorities, which may differ between university-based and community-based programs. In both types of programs, these competing needs are a source of faculty dissatisfaction and burnout. We performed this study to explore the allocation of nonclinical administrative full-time equivalents (FTE) for FM residency core faculty members.

RESULTS: Reported nonclinical administrative FTE time allocation is equivalent between university/medical school-based and community-based programs. The …

The Shared Experiences Of Novice, Full-Time Allied Dental Community College Educators, Misty L. Mesimer

Educational Leadership & Workforce Development Theses & Dissertations

A well-prepared oral healthcare workforce is essential to the overall health of the general population. A knowledgeable and qualified workforce would be non-existent without strong academic programs and faculty to prepare oral health professionals. For over 20 years, the dental and allied dental educator workforce has been a concern for the oral health professions. Since most allied dental education programs are based in community and technical colleges, it is crucial to thoroughly understand the transition experiences of faculty teaching at these institutions. It is only through application and use of this knowledge that these faculty can be recruited, supported, and …

The Heart Of Residency, Julia Fashner, Samantha Gionocchio

HCA Healthcare Journal of Medicine

As part of wellness activities in 2023, our family medicine residents produced individual paintings. Samantha coalesced these 4 x 4 canvases to create this heart. The following quote is also poignant for those of us in family medicine:

Wherever the art of Medicine is loved there is also a love of Humanity. -Hippocrates

Well-Being And Leadership Within The Emergency Department, Jacob T. Berg, Thomas Matese, Dennis Anthony Cardriche, David Hotwagner

HCA Healthcare Journal of Medicine

This article looks at well-being and the role of leadership from the perspective of emergency medicine. The importance of leadership within the emergency department (ED), emergency medicine writing at large, and the prevention of burnout and compassion fatigue cannot be overstated. This article looks at the need for more research and measured interventions within the ED. It also highlights some measures that could be taken to help improve well-being from a leadership perspective to improve patient safety and outcomes within the ED.

A Resident Led Newsletter Is A Powerful Communication Tool, Jonathan Brown, Zuhair Ali, An Dao, Mike Wong, Rajeev Raghavan

HCA Healthcare Journal of Medicine

Background

Communication with stakeholders for a graduate medical education (GME) program depends on shared visual and written content. Residency training programs are embracing social media as a communication channel. However, curated information that may only be viewed by subscribers or followers is difficult to archive and may appear overwhelming to novice users. An electronic, printable newsletter may be a unique communication tool for training programs to share information among residents, faculty, and hospital administration.

Methods

We published a monthly electronic newsletter sent to all residents, teaching faculty, and additional stakeholders in our internal medicine residency program. We conducted an electronic …

The Feasibility And Impact Of An Asynchronous Interprofessional Well-Being Course On Burnout In Health Care Professionals, Mari Ricker, Audrey J. Brooks, Mei-Kuang Chen, Joy Weydert, Amy Locke, E Kyle Meehan, Paula Cook, Patricia Lebensohn, Victoria Maizes

HCA Healthcare Journal of Medicine

Background

Well-being initiatives are essential components in fostering an engaged workforce and creating an effective health care ecosystem. Health care professional (HCP) burnout is widespread and has worsened since the COVID-19 pandemic. In 2014, with Health Resources and Services Administration funding support, the Andrew Weil Center for Integrative Medicine created an online course for HCP well-being. It was subsequently studied in medical residents and revised in 2020. In this study, we explore the impact of the course across larger systems, as well as the long-term impact on HCPs.

Methods

The Health Care Professional Well-Being course is 4.5 hours of interactive …

Resident Feedback On Incorporating Reflection Rounds Into A Family Medicine Residency Wellness Curriculum: A Brief Report, Stacy Ogbeide, Jasmin Aldridge Hamlett, Inez Isabel Cruz

HCA Healthcare Journal of Medicine

Background

We sought to understand well-being from the perspectives of residents in a family medicine residency program and to assess the residents’ opinions on implementing “Reflection Rounds” (RR) to promote wellness and combat burnout through self-reflection. These aims were achieved through descriptive qualitative analysis of a focus group of family medicine residents.

Methods

Participation was voluntary and open to all 45 residents in the program. The final participant sample consisted of 14 residents who shared similar characteristics, including level of training and being exposed to similar training stressors. Both a priori and open coding were used for this analysis.

Results …

A Multi-Wave Study Of Factors Associated With Resident Engagement, Depression, Burnout, And Stay Intent, Anne M. Brafford, Brendon Ellis, Greg Guldner, Gabrielle Riazi, Xitao Liu, Jessica C. Wells, Jason T. Siegel

HCA Healthcare Journal of Medicine

Background

Many studies have documented the epidemic of mental ill-being among resident physicians, but fewer have focused on mental well-being or on guiding intervention design to make progress toward positive change in residency programs to support resident thriving. Informed by the job demands-resources model (JD-R) and positive psychology, the current study examines 4 potential predictors of residents’ ill-being (burnout, depression) and well-being (engagement, stay intent) that are malleable and thus capable of change through intervention: psychological capital (PsyCap), supervising physicians’ autonomy-supportive leadership style (ASL), social support, and meaningful work.

Methods

Three waves of data were collected between November 2017 and …

Perceived Disruption Of Covid-19 On Medical Education In Incoming Psychiatric Residents, Steven Sprenger, Ashley Mahajan, Jeffrey Anderson, Napatkamon Ayutyanont, Jessica C. Wells, Gregory Guldner

HCA Healthcare Journal of Medicine

Background

In 2020, the global COVID-19 pandemic caused educational disruptions to many medical students nationally. Societal and hospital guidelines, including social distancing protocols, resulted in the cancellation or postponement of many elective procedures. A shortage in personal protective equipment also contributed to restrictions in clinical experiences for trainees. The purpose of this study was to determine resident-perceived preparedness in core clinical competencies and evaluate the disruptions to core clerkships.

Methods

A survey was developed to assess self-perceptions of clinical competencies and disruptions to core clerkship experiences. It was distributed to 63 incoming psychiatric residents who were matched to training programs …

The Effects Of The Covid-19 Pandemic On Resident Education And Burnout, Timbre Backen, Oliwier Dziadkowiec, Jeffery S. Durbin, Gregory Guldner, Glenda Quan

HCA Healthcare Journal of Medicine

Background

The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic.

Methods

We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using …

Learning From Health Care Counselors’ Perspectives On Health Care Worker Distress: A Qualitative Analysis, Nancy Downs, Judy Davidson, Angela Haddad, Sidney Zisook

HCA Healthcare Journal of Medicine

Background

Health care provider stress and emotional distress were well documented long before the COVID-19 pandemic, and there is growing data suggesting these have increased in response to the pandemic. The goal of this study was to take advantage of the unique experiences of licensed mental health (MH) clinicians working with health care trainees and clinicians before and during the pandemic to identify how this crisis affected both ongoing as well as new sources of stress. The Healer Education, Assessment and Referral Program (HEAR) provides MH screening, support, and MH referrals to ~19 000 health care students, trainees, staff, and …

A Qualitative Follow-Up To A Survey Of Program Directors On Wellness Programming At A Large Healthcare Organization: Interviews Of High- And Low-Exemplar Programs, Sabrina Menezes, Kelsey M. Carpenter, Alexander W. Marshburn, Stephanie Ramirez, Gregory Guldner, Jessica C. Wells, Jason T. Siegel

HCA Healthcare Journal of Medicine

Background

The current research used a qualitative approach to understand which factors facilitate and hinder wellness programming in residency programs.

Methods

Program directors identified from a previous quantitative study as having residency programs with notably more or less resident wellness programming than others (ie, high- and low-exemplars, respectively) were contacted. In total, semi-structured interviews were conducted over Zoom with 7 low-exemplars and 9 high-exemplars.

Results

The results of this qualitative examination suggest common themes across the 2 exemplar groups, such as wanting more resources for resident wellness with fewer barriers to implementation, viewing wellness as purpose-driven, and seeing wellness as …

A Nation-Wide Survey Of Program Directors At A Large Health Care Organization: Prevalence And Perceptions Of Resident Wellness Activities, Alexander W. Marshburn, Gabrielle Riazi, Sabrina Menezes, Stephanie Ramirez, Gregory Guldner, Jessica C. Wells, Jason T. Siegel

HCA Healthcare Journal of Medicine

Background

This study evaluated wellness programs in a large hospital network to determine residency program directors’ (PDs) perspectives on their wellness programs' state, including wellness prioritization, frequency of wellness activities, and wellness’ influence on decision-making across organizational levels.

Methods

In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration’s ability to prioritize wellness, funding sources, and perceptions of resident wellness’ impact on decision-making.

Results

Among 211 contacted programs, 148 surveys were completed (70.1%). The majority reported having wellness programs, committees, and funding. Fewer than 25% reported having a chief wellness officer. PDs perceived …

Burnout In Graduate Medical Education: Uncovering Resident Burnout Profiles Using Cluster Analysis, Nicholas A. Yaghmour, Nastassia M. Savage, Paul H. Rockey, Sally A. Santen, Kristen E. Decarlo, Grace Hickam, Joanne G. Schwartzberg, Dewitt C. Baldwin Jr., Robert A. Perera

HCA Healthcare Journal of Medicine

Background

Burnout is common among residents and negatively impacts patient care and professional development. Residents vary in terms of their experience of burnout. Our objective was to employ cluster analysis, a statistical method of separating participants into discrete groups based on response patterns, to uncover resident burnout profiles using the exhaustion and engagement sub-scales of the Oldenburg Burnout Inventory (OLBI) in a cross-sectional, multispecialty survey of United States medical residents.

Methods

The 2017 ACGME resident survey provided residents with an optional, anonymous addendum containing 3 engagement and 3 exhaustion items from the OBLI, a 2-item depression screen (PHQ-2), general queries …

Exercise Is A Vital Sign, Megan Dannemiller, Anthony Shadiack, Marvin Sineath Jr, Andrew Baird, Marc Poirier, Kevin Thomas, Michael G. Flynn

HCA Healthcare Journal of Medicine

In this review, we argue that exercise (physical activity) be monitored as a vital sign since no other basic sign or symptom provides as much information about a patient's health status. The influence of regular exercise on patient health is indisputable, with strong evidence to show the power of exercise to mitigate chronic disease and improve overall health. Several simple tools, such as Physical Activity as a Vital Sign and Exercise as a Vital Sign are available to assess patient physical activity. When properly applied, there is evidence to support the efficacy of these tools, but there are barriers that …

Autonomy Versus Independence: Implications For Resident And Faculty Engagement, Performance, And Well-Being, Adam P. Neufeld, C. Scott Rigby

HCA Healthcare Journal of Medicine

Research shows that when educational leaders support their learners’ autonomy, it positively impacts both parties. This is particularly important in graduate medical education (GME), given that there is a strong emphasis on resident performance, evaluation, and development. Unfortunately, GME faculty often misunderstand autonomy as the resident’s desire for independence or “freedom,” when in fact it refers to the core psychological need to feel volitional and agentic. The distinction is important because volition is not synonymous with independence, and providing freedom can be at odds with strategies that provide true autonomy support. This, in turn, can contribute to the stress, maladjustment, …

What Motivates You?, Mohamad S. Saad

HCA Healthcare Journal of Medicine

For over 100 years, we have tried to understand how human motivation works. Although various theories have been developed and different experiments have been conducted to explain motivational drive, we have realized that extrinsic motivation factors, such as rewards and punishment, and financial incentives are not the answers. More important and central to motivation is nourishing our innate human need to be autonomous, competent, and to relate to our organizational culture. All of us need to understand the story of motivation because, as dire as our need for high-quality motivation is, high-quality motivation remains an asymptote.

Addressing Burnout And Enhancing Well-Being Among Academic Physicians: A Call For Future Research And Organizational Support, Kelly D. Holder, Sharon Y. Lee, Fatima Zehra Raza, Laura R. Stroud

HCA Healthcare Journal of Medicine

Burnout among academic physicians, who navigate multiple roles beyond the clinical environment, is a pressing issue. However, the factors driving burnout among academic physicians are not fully understood. Prior research has revealed differences in burnout dimensions between clinical and basic science faculty, but the impact of balancing research, education, and clinical demands on academic physicians is still unclear. This knowledge gap negatively affects the clinical, translational science, research, and medical education workforces and has particular implications for minoritized and marginalized groups working in academic medical centers. Creating a culture of well-being has been vital in addressing burnout. Further research is …

Empowering Voices: Cultivating A Supportive Network From The Women In Medicine And Health Care Symposium, Rutuja D. Bhalerao, Kyle Mefferd, Jocelyn A. Limas

HCA Healthcare Journal of Medicine

There are many studies, some discussed in this article, that recognize the numerous issues faced by women in medicine and the health care field. In response to the prevalence of these challenges, Riverside Community Hospital’s General Medical Education department organized the second Women in Medicine & Healthcare Symposium on November 17, 2023. The symposium featured a panel of women leaders addressing challenges, such as work-life balance, maternity leave, fertility concerns, and family planning. Personal stories and studies on gender bias and infertility shed light on the shared experiences of women physicians. The positive response prompted Riverside Community Hospital to view …

Creating And Supporting Well-Being In Graduate Medical Education, Gregory Guldner

HCA Healthcare Journal of Medicine

Graduate medical education strives to create the next generation of skillful and compassionate physicians for our nation. Yet, research shows a high degree of depression, anxiety, workplace burnout, lack of engagement, and general dissatisfaction with the work and learning environment for many of these dedicated individuals. We present this special issue related to creating and supporting well-being in the graduate medical education community.

Review Of Mpges-1 Inhibitors Based On The Benzoxazole And Its Isostere Scaffold For The Treatment Of Inflammatory Diseases, Abdullah M. Alwagdani

Longitudinal Scholar's Project

The vital role of the prostanoid pathway in inflammation, pain, cancer, Alzheimer’s and many other diseases has attracted the drug discovery community to discover targets for therapeutic development. Although existing non-steroidal anti-inflammatory drugs (NSAIDs) inhibiting cyclooxygenases (COX) are widely used, the side effects of these NSAIDs limit the ling time medication. Microsomal prostaglandin E synthase-1 (mPGES-1) is an attractive target that is overexpressed during inflammations, and it could be a safe alternative to NSAIDs for treating inflammatory diseases.Since the discovery of mPGES-1 in 1997, many inhibitors have been developed since 2001. Only a few compounds were able to make it …

Pbpa Creating Pathways To Ensure Patients Are Using Their Inhaled Medications Effectively, Suzan Michelle Collins, Heather Blake, Chandler Blodgett, Sue Vermette, Martine Eon

Operations Transformation

Problem: Patients do not consistently know how to prepare, use and/or clean their inhalers effectively.

Impact: When patients do not consistently know how to prepare, use and/or clean their inhalers effectively they are in fact, not receiving the benefit from their prescribed medication.

They experience poor patient outcomes and overall poor patient experience.

• Increased calls to provider offices for unresolved, worsening symptoms and/or complications. (Thrush, hoarseness, cardiac symptoms etc.)
• Increased same day office visits.
• Patient crowding in Urgent Care and/or Emergency Department.
• Hospital Admissions.
• Increase in emotional and financial stress from missing school and/or work.
• Increase in referrals to specialists …

عدوى المستشفيات, Afaf Taha

Al Jinan الجنان

Despite the progress in the medical fields and technologies used, and the use of a number of antibiotics to eliminate microorganisms that attack the human body, bacterial infections still a major cause of patient deaths. The irony is that hospitals patients turn to for hospitalization are the source of infection caused by microorganisms resistant to a number of antibiotics. The researcher discusses this problem and tells us that the hospital is an ideal place for transmitting pathogens because patients with similar diseases placed in closed groups and are in contact with health workers so that both become a hotbed for …

Inter-Institutional Analysis Of Skin Of Color Representation In Dermatological Lecture Content At Md And Do Medical Schools, Oluwafunke Ogunremi

Sanford School of Medicine Posters and Presentations

The purpose of this study was to analyze the lecture materials provided in medical schools through a diversity lens. Skin pathologies manifest distinctively on various shades of skin and physicians must be equipped with the proper knowledge to identify and diagnose these conditions accurately and promptly. For most medical students, images in prominent textbooks and lecture slides are their first encounter with disease presentations. Therefore, it is important to analyze the diversity of skin tones in the content that is being delivered. Specifically, the use of images featuring darker skin tones compared to those depicting lighter skin tones. This study …

The Cognitive And Affective Empathy Of Doctor Of Physical Therapy Students Vs. Specialty Choice, Bruce W. Newton, Michelle Green, Zachary Vaskalis

Internet Journal of Allied Health Sciences and Practice

Purpose: This modified cross-sectional study was performed to determine which specialties DPT students desire to enter, and how affective and cognitive empathy is related to the specialty choice. There are two types of empathy: affective and cognitive. Affective empathy from an emotionally charged situation enters the CNS of a person first and is followed by a cognitive empathic response. Methods: Affective empathy was measured using the Balanced Emotional Empathy Scale (BEES) and cognitive empathy was measured using the Jefferson Scale of Empathy-Health Professions Student (JSE-HPS) version. Each student was asked to indicate which specialty they desired to enter: cardiopulmonary, geriatrics, …

Intouch Week Of June 24, 2024, New York Medical College

InTouch

• Teeing Off for Tomorrow’s Scholars at the Golf Outing
• New Medical School Linkage Agreement for GSBMS Students
• Dr. Halperin Offers Thoughts on the American Hearing Aid Market
• Scarring Persists in Patients with COVID-19 Vaccine-Associated Myocarditis
• Study Suggests Diagnostic Surgery Can Be Used Safely on Children with Epilepsy
• Department Spotlight: The Office of Government Affairs Advances the College’s Mission, Education, and Research
• Alumni Spotlight: Dr. Mboge Plants Seeds of Change from The Gambia to New York

Doctor Who?: Norms, Care, And Autonomy In The Attitudes Of Medical Students Towards Ai Pre And Post Chatgpt, Andrew Prahl, Kevin Tong Weng Jin

Human-Machine Communication

This study adopts the combined TAM-TPB model to investigate attitudes and expectations of machines at a pre-career stage. We study how future doctors (medical students) expect to interact with future AI machinery, what AI usage norms will develop, and beliefs about human and machine autonomy. Semi-structured interviews were conducted. Wave one occurred six-months prior to the public release of ChatGPT; wave two occurred in the 6 months following. Three themes emerged: AI is tomorrow, wishing for the AI ouvrier, and human contrasts. Two differences were noted pre- versus post-ChatGPT: (1) participants began to view machinery instead of themselves as the …